In Eastern Europe and Central Asia (EECA), achieving universal access to health care for people in prison faces serious barriers. The penitentiary sector often operates separate health care systems, which prevents universal approaches to accessing services and continuity of these services between the prison and civilian sectors. In addition, data on the health status of people in prison are not included in national statistical indicators measuring progress toward universal health coverage. This leads to an underestimation of existing inequalities and makes it difficult to develop effective strategies to improve prison health care.
According to the World Health Organization (WHO), nine countries in the EECA region account for 16% of the global burden of multidrug-resistant tuberculosis (MDR-TB). In 2020, Kyrgyzstan, Tajikistan, and Uzbekistan had health expenditures of 4.5%, 7.1%, and 5.6% of GDP, respectively. However, these figures do not reflect the state of health care in penitentiaries, where the prevalence of diseases such as TB and HIV is significantly higher than in the general population.
Inadequate funding, lack of qualified medical staff, and limited resources in prisons result in people in prison having restricted access to necessary treatment and preventive services. In addition, stigma and discrimination against access to quality health care.
Overcoming these barriers requires:
– Prison health care reforms, particularly the integration of health care services for people in prison into nationwide service delivery systems for the general population;
– Data integration: incorporating prison health statistics into national indicators will allow for a more accurate assessment of the situation and the development of targeted programs.
– Intersectoral collaboration: improving coordination between the Ministries of Health and Justice/Homeland Affairs to ensure continuity of care.
Increased funding: ensuring adequate resources for health services in prisons, including staff training and provision of necessary medication.
– Combating discrimination: conducting information campaigns to reduce stigma and ensure equal access to health services for all, including prisoners.
In this context, the role of the Eurasian Movement for the Right to Health in Prisons is to bring together national governments, prison services, community organizations, international agencies, and experts to improve access to health services in prisons in the region. The Movement’s objectives include promoting the integration of prison health services into national health systems and ensuring human rights in prisons. Their work aims to develop an integrated approach to prison health care and reduce barriers to realizing their right to access health services.
Last year, we held a regional consultation on “Prospects for Reforming Prison Medicine in Eastern Europe and Central Asia”, where participants from Kazakhstan, Moldova, and Ukraine learned about Armenia’s experience in transferring health care functions from the prison service to the Ministry of Health, and discussed the prospects for implementing similar reforms in their countries. This year we will continue to actively work on reducing barriers to access to health services for people in prison,” says Anna Koshikova, Executive Director of the Eurasian Movement for the Right to Health in Prisons.